A survey by the National Association of Private Hospitals (Anahp), an association that represents a group of more than 120 private hospitals, showed that, from 2019 to 2023, there was a reduction in the number of outpatient consultations, hospitalizations and therapies per patient. However, there was an increase in exams and medical care in emergency rooms.
The survey shows that the number of outpatient consultations per patient fell from 4.7 in 2019 to 4.1 in 2023, or 12%. Hospitalizations fell from 0.193 to 0.189 per patient in the 5 years, a drop of 2%, while dental procedures decreased from 6.6 to 5.7, a drop of 13%, and therapies went from 1.7 to 1.6, a reduction of 8%.
The number of exams increased during the period, rising from 19.8 to 23.4, an increase of 18%. Medical care in emergency rooms also increased (4%).
In comparison with 2022, however, an increase of almost 3% was found in the number of hospitalizations per patient, since in that year the calculated average was 0.184.
Operators
The Anahp survey also showed that health plan operators presented a positive net financial result of R$5.1 billion in the first half of this year, which represents around 3.5% of what the companies collected from the fees paid by the 51 million beneficiaries of these plans in the period, the so-called premium, which reached R$147.41 billion.
Health plans disbursed 83% of these premiums on payments for medical procedures to users of these plans, that is, R$123.02 billion. This percentage, called the loss ratio, was lower than those observed in the 12 months of 2021 (87%), 2022 (89%) and 2023 (87%), years in which the plans closed with losses of 1.6%, 9.9% and 9.2%, respectively.
According to the research, the variation in medical and hospital costs in the country reached 11.66% in 2023, above the 8.78% in 2022, but below the 13.86% in 2019. Since 2014, these costs have varied above the official inflation, with the exception of 2020, the year the pandemic began, when they fell 8.45%.
Official inflation in 2023, for example, was 4.62%. In 2022, it was 5.79%. “Looking at 100% of beneficiaries and the variation in their per capita cost, we have the news that everyone knows, that medical costs vary above the costs of general inflation”, says Luiz Feitoza, one of those responsible for the study.
According to Feitoza, the variation is calculated based on the demand for services and the actual cost of the procedures. And the main reason for the positive variation of the indicator in the accumulated 10 years, between 2014 and 2023, was the actual cost, which grew 119.8%, while demand rose only 23.22%.
The variation in hospital medical costs in 2023 was heavily pressured by the increase in the cost of therapies, according to the study.
“The crisis in supplementary healthcare must be vigorously addressed by identifying the real reasons. We are seeking to do this with a survey and technical assessment from a financial and operational perspective. For example, we have identified that health insurance users are having fewer medical appointments, hospitalizations and therapies. However, on the other hand, costs have increased significantly, such as therapies, which have grown 40% per procedure, in real terms discounting the IPCA, over the last five years,” says Antônio Britto, executive director of Anahp.
